Bloodied, broken and burned out: 88% of long-term care staff experience violence

Mar 26, 2019

Two new reports are being released concurrently that expose the high level of violence, abuse and harassment against staff employed in Ontario’s long-term care homes.

An in-depth, peer-reviewed investigative study on violence against staff in Ontario long-term care homes has just been published. The study Breaking Point: Violence Against Long-term Care Staff was conducted by Canadian researchers, Dr. James Brophy and Dr. Margaret Keith, who are associated with the University of Windsor and the University of Stirling in the UK. They held group interviews with long-term care staff in seven Ontario communities.

What the researchers heard is that long-term care staff are bloodied and broken both physically and psychologically.

“Long-term care homes in Ontario are largely staffed by women. Their work is based on compassion and care,” says Dr. Keith. “And yet, they themselves are expected to tolerate an environment in which physical, verbal, racial and sexual aggression are rampant. Adding to their burden is the implicit threat that they will be disciplined or fired if they speak publicly about these abuses.”

Many of the study subjects agreed with one participant who summarized her experiences with workplace violence as follows:

“I’ve been kicked. I’ve been scratched. Last night I got punched in the back. I’ve had shoes, hats, everything thrown at me. There’s not a day that I haven’t been abused whether it’s verbal or physical. Ever.”

The study revealed a largely overlooked culture of abuse, a lack of uniform protections and regulations, understaffing and underfunding, as well as resulting high levels of stress and burnout among the front-line care givers.

“We found that physical, sexual and verbal abuse have been allowed to become normalized within the long-term care work environment,” Dr. Brophy said. “We believe the health and well-being of health care staff reflect the health of the health care system itself and, therefore, these findings should precipitate a critical examination of the institutional factors that allow for such high levels of violence.”

In a second-related investigation, front-line, long-term care staff were polled on their experiences with workplace violence based on job roles and gender within long‐term care facilities in Ontario. Public Polling conducted the telephone poll, commissioned by the Ontario Council of Hospital Unions (OCHU/CUPE) and the Ontario division of CUPE.

The poll found that:

  • 88% of personal support workers (PSWs) and Registered Practical Nurses (RPNs) experience physical violence.
  • 62% of the PSWs and 51% of the RPNs experience at least one incident of physical violence each week.
  • 69% of racialized, indigenous and minority staff experience related harassment.
  • 75% of all respondents believe that they are not able to provide adequate care due to workload and low staffing.
  • 69% of nurses and personal support workers acknowledge wanting to leave their jobs.

“The extremely high level of verbal, sexual and physical violence against long-term care staff described by our polling should concern everyone who works in, or is resident in, or who has a family member in long-term care in Ontario. An environment this violent and degrading for long-term care workers must surely also be unsafe for residents. These results paint a grim picture of a scandalously unsafe environment – we should not believe that this culture cannot be changed. Violence should never be seen as part of the job,” said Candace Rennick, CUPE Ontario secretary-treasurer and former PSW.

The study, featured in NEW SOLUTIONS: A Journal of Environmental and Occupational Health Policy was released along with the poll results at Queen’s Park today.

Similar study and poll releases are planned for several communities across Ontario as part of a campaign to highlight the issues affecting the long-term care workforce. These communities include Hamilton, Kitchener, Kingston, Cornwall, Ottawa, Sudbury, North Bay, Sarnia, London, Toronto and Peterborough with the final campaign stop April 10 in Oshawa

Michael Hurley, president of the OCHU/CUPE who collaborated with Dr. Brophy and Dr. Keith on the research study said “this study and the polling results reflect the anguish and emotional and psychological pain of the long-term care workforce in the face of an unrelenting wave of verbal, racial, sexual and physical violence. We call on the provincial government to adopt minimum staffing levels in long-term care and statutory protection for staff who report or speak up about the problem of violence. We call on the federal government to treat sexual and physical assaults against health care staff by mentally competent persons as a serious criminal offence.”


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